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NPI Code Detail

MEDICARE: SHORE PHARMACEUTICAL PROVIDERS LLC

MEDICARE: SHORE PHARMACEUTICAL PROVIDERS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336L0003XLong Term Care Pharmacy

General Provider Information

NPI Number : 1184648511
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHORE PHARMACEUTICAL PROVIDERS LLC
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line : BOX 1075
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 55 W AMES CT
Second Line : SUITE 200
City : PLAINVIEW
State : NY
Zip : 11803-2304
Country : US
Telephone Number : 516-938-8080
Fax Number :
Authorized Official
Title or Position : SR DIRECTOR, PAYER RELATIONS
Name : SUSAN COLBERT
Credential :
Telephone Number : 401-770-2751
Provider Enumeration Date : 07/27/2006
Last Update Date : 03/11/2019

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Directions to “SHORE PHARMACEUTICAL PROVIDERS LLC ” Practice Location

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